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The Atkins Diet
The Atkins diet, officially called the Atkins Nutritional Approach, is a low-carbohydrate diet promoted by Robert Atkins from a research paper he read in The Journal of the American Medical Association published by Alfred W. Pennington, titled "Weight Reduction", published in 1958.[1] Atkins used the study to resolve his own overweight condition. He later popularized the method in a series of books, starting with Dr. Atkins' Diet Revolution in 1972. In his second book, Dr. Atkins' New Diet Revolution (2002), he modified parts of the diet but did not alter the original concepts. The New Atkins for a New You (2010) is based upon a broad array of information gained over the last decade not covered in previous editions, including nutrient-rich foods. The New Atkins for a New You Cookbook was released in 2011 by Colette Heimowitz to provide dieters with simple, low-carb recipes. Hamm went on this diet in Healthy Hamm. Nature of the diet The Atkins diet involves limited consumption of carbohydrates to switch the body's metabolism from metabolizing glucose as energy over to converting stored body fat to energy. This process, called ketosis, begins when insulin levels are low; in normal humans, insulin is lowest when blood glucose levels are low (mostly before eating). Reduced insulin levels induces lipolysis which consumes fat to produce ketone bodies. On the other hand, caloric carbohydrates (for example, glucose or starch, the latter made of chains of glucose) affect the body by increasing blood sugar after consumption (in the treatment of diabetes, blood sugar levels are used [2]) Fiber, because of its low digestibility, provides little or no food energy and does not significantly affect glucose and insulin levels. In his early books such as Dr Atkins' New Diet Revolution, Atkins made the controversial argument that the low-carbohydrate diet produces a metabolic advantage because "burning fat takes more calories so you expend more calories".[3] He cited one study where he estimated this advantage to be 950 calories (4.0 MJ) per day. A review study published in Lancet[4] concluded that there was no such metabolic advantage and dieters were simply eating fewer calories because of boredom. Professor Astrup stated, "The monotony and simplicity of the diet could inhibit appetite and food intake". In the most recent book by Drs. Westman, Phinney, and Volek, the authors suggest optimal levels of protein, fat, and calorie intake, and have moved away from the metabolic advantage theory. The Atkins Diet restricts "net carbs" (digestible carbohydrate grams that affect blood sugar less fiber grams). One effect is a tendency to decrease the onset of hunger, perhaps because of longer duration of digestion (fats and proteins take longer to digest than carbohydrates). Atkins states in his 2002 book New Diet Revolution that hunger is the number one reason that low-fat diets fail, and that the Atkins diet is easier because one is satisfied with adequate protein, fat and fiber.[3] Net carbohydrates can be calculated from a food source by subtracting fiber and sugar alcohols (which are shown to have a smaller effect on blood sugar levels)[citation needed] from total carbohydrates. Sugar alcohols contain about two calories per gram, and the American Diabetes Association recommends that diabetics count each gram as half a gram of carbohydrate.[5] Fructose (for example, as found in many industrial sweeteners) has four calories per gram but has a very low glycemic index[6] and does not cause insulin production, probably because β cells have low levels of GLUT5.[7][8] Leptin, an appetite regulating hormone, is however not triggered following consumption of fructose. This may for some create an unsatisfying feeling after consumption which might promote binge behavior that culminates in an increased blood triglyceride level arising from fructose conversion by the liver.[9] Preferred foods in all categories are whole, unprocessed foods with a low glycemic index, although restrictions for low glycemic carbohydrates (black rice, vegetables, etc.) are the same as those for high glycemic carbohydrates (sugar, white bread). Atkins Nutritionals, the company formed to market foods that work with the Atkins Diet, recommends that no more than 20% of calories eaten while on the diet come from saturated fat.[10] Atkins' book, Atkins Diabetes Revolution, states that, for people whose blood sugar is abnormally high or who have Type 2 diabetes mellitus, the Atkins diet decreases or eliminates the need for drugs to treat these conditions. The Atkins Blood Sugar Control Program (ABSCP) is an individualized approach to weight control and permanent management of the risk factors for diabetes and cardiovascular disease.[11] Nevertheless, the causes of Type 2 diabetes remain obscure, and the Atkins Diet is not accepted in conventional therapy for diabetes. Ketogenic diet The initial stage of the Atkins diet is referred to as the induction phase and is considered a ketogenic diet. In ketogenic diets there is production of ketones that contribute to the energy production in the Krebs cycle.[12] Ketogenic diets rely on the insulin response to blood glucose. Insulin is a hormone produced by beta-cells in the pancreas in response to high levels of blood glucose (i.e. after digestion of a carbohydrate meal). The main function of insulin is to shuttle glucose from the blood to peripheral tissues, where they will be needed for fuel or stored as fat. Thus, insulin is a regulator of blood glucose that is too high. Because ketogenic dieters eat few carbohydrates, there is no glucose that can trigger the insulin response. Therefore, the body must seek an alternate fuel source to fulfill its metabolic needs. During this diet, the main sources of fuel for human cells (glucose) is now at less than adequate supply, cells must take alternate steps to convert stored fuel to glucose. Other than carbohydrate ingestion (which is directly converted into glucose and then immediately available for use as fuel when it enters the blood), the cells must rely on glucose production from conversion of either protein (amino acids) or stored fat. When blood levels of glucose are low, regulating hormones are released to signal for the need to elevate blood sugar. This is in contrast to the actions of insulin. Since the body is less able to compensate for a state of hypoglycemia, than it is for hyperglycemia, hormones (growth hormone, epinepherine, cortisol, and glucagon) are released causing a cascade resulting in glycogen release from the liver and adipose(fat) cell conversion of triacylglycerol to fatty acids. Blood glucose levels have to decrease to less than 3.58 mmol/L (64.5 mg/dl) for growth hormone, epinephrine, and glucagon to be released to maintain energy metabolism.[12] In the adipose cells, growth hormone and epinephrine initiate the triacylglycerol to be broken down to fatty acids. These fatty acids go to the liver and muscle where they should beoxidized and give acetyl-CoA that enters the Krebs cycle directly.[12] However, the excess acetyl-CoA in the liver is converted to ketones (ketone bodies), that are transported to other tissues. In these tissues they are converted back into acetyl-CoA in order to enter the Krebs cycle. Glucagon is produced when blood glucose is too low, and it causes the liver to start breaking glycogen into glucose. Since the dieter does not eat any more carbohydrates, there is no glycogen in the liver to be broken down, so the liver converts fats into free fatty acids and ketone bodies, and this process is called ketosis. Because of this, the body is forced to use fats as a primary fuel source. The four phases Inductionhttp://en.wikipedia.org/w/index.php?title=Atkins_diet&action=edit&section=7 edit Induction is the most restrictive phase of the Atkins Nutritional Approach. Two weeks are recommended for this phase. It is intended to cause the body to quickly enter a state ofketosis. Carbohydrate intake is limited to less than 20 net grams per day (grams of carbohydrates minus grams of fiber, sugar alcohols, or glycerin), 12 to 15 net grams of which must come in the form of salad greens and other fruits and vegetables such as broccoli, spinach, pumpkin, cauliflower, turnips, tomatoes, and asparagus, to name a few of the 54 allowed by Atkins (but not legumes, since they are too starchy for the induction phase). The allowed foods include 4 to 6 ounces per meal of all meats, poultry, fish, shellfish, fowl, and eggs; up to 4 ounces (113 g) of hard or semi-soft cheese such as cheddar cheese; most salad vegetables; other low carbohydrate vegetables; and butter, olive oil and vegetable oils. Drinking eight glasses of water per day is a requirement during this phase. Alcoholic beverages are not allowed during this phase.[19] Caffeine is allowed in moderation so long as it does not cause cravings or low blood sugar. If a caffeine addiction is evident, it is best to not allow it until later phases of the diet.[19] A daily multivitamin with minerals, except iron, is also recommended.[19] A normal amount of food, on Induction, is around 20 grams of naturally occurring sugars from vegetables (or net carb), at least 100 grams of fat, and about 18 ounces of protein or 150 grams. The Induction phase is usually when many see the most significant weight loss — reports of losses of 5 to 10 pounds per week are not uncommon when Induction is combined with daily exercise[citation needed]. Many Atkins followers make use of Ketostix, small chemically reactive strips used by diabetics, but current recommendations discourage use due to inaccurate readings. These let the dieter monitor when they enter the ketosis, or fat burning phase, but are not always accurate for non-diabetic users. Other indicators of ketosis include a metallic taste in the mouth, or the sweet smell of ketones on breath or sweat. Ongoing weight losshttp://en.wikipedia.org/w/index.php?title=Atkins_diet&action=edit&section=8 edit The Ongoing Weight Loss (OWL) phase of Atkins consists of small, incremental increase in carbohydrate intake, but remaining at levels where weight loss occurs. The target daily carbohydrate intake increases each week by 5 net grams, a very low amount of carbohydrate. A goal in "ongoing" phase is to find the "Critical Carbohydrate Level for Losing" for the individual and to determine which foods an individual may incorporate without triggering cravings. This phase of the Atkins' diet lasts until weight is within 10 pounds (4.5 kg) of the target weight. During the first week of Ongoing Weight Loss, Atkins dieters are instructed to add a small additional serving of the induction acceptable vegetables. For example, 6-8 stalks of asparagus, one cup of cauliflower or one half of an avocado. The next week, one should follow the carbohydrate ladder that Dr Atkins created for this phase and add cheese. The ladder has 9 rungs and should be added in the following order. One can skip a rung if one does not intend to include that food group in one's permanent way of eating, such as the alcohol rung. The rungs for legumes, high carbohydrate fruits, starchy vegetables, and whole grains are not added until the maintenance phase. They are then incorporated in modest amounts. The rungs are as follows: *increase acceptable vegetables *Cheese *Nuts and seeds *Berries *Alcohol *Legumes *Other fruits *Starchy vegetables *Whole grains Pre-maintenancehttp://en.wikipedia.org/w/index.php?title=Atkins_diet&action=edit&section=9 edit Daily net carbohydrates intake is increased again this time by 10 grams each week from the latter groupings, and the key goal in this phase is to find the "Critical Carbohydrate Level for Maintenance". This is the maximum number of carbohydrates a dieter can eat each day without gaining weight. This may well be above the level of carbohydrates that induce ketosis on a testing stick. As a result, it is not necessary to maintain a positive ketosis test long term. Dieters may be able to add some of the forbidden carbs back into their diet once a week. In this phase, according to the Atkins diet, one's body is beginning to lose the protection of ketosis as one prepares for the last phase which is Lifetime Maintenance. Dieters are encouraged to continue to drink at least eight glasses of water per day and to increase their daily carbohydrate count by 10 grams each week as long as they continue to lose weight. The Atkins plan recommends that once dieters reach their goal weight and are able to maintain that level for a month or so, then they can increase their daily carb consumption by another 10 grams to see if that is possible without gaining. If one gains weight at that level, the plan recommends that one drops back levels of carbohydrates in 10 grams increments. It may take several weeks to find one's individual tipping point. Lifetime maintenancehttp://en.wikipedia.org/w/index.php?title=Atkins_diet&action=edit&section=10 edit This phase is intended to carry on the habits acquired in the previous phases, and avoid the common end-of-diet mindset that can return people to their previous habits and previous weight. Whole, unprocessed food choices are emphasized, with the option to drop back to an earlier phase if you begin to gain weight. The Atkins Nutritional Approach gained widespread popularity in 2003 and 2004. At the height of its popularity one in eleven North American adults was on the diet.[20] This large following was blamed for large declines in the sales of carbohydrate-heavy foods like pasta and rice: sales were down 8.2 and 4.6 percent, respectively, in 2003. The diet's success was even blamed for a decline in Krispy Kreme sales.[21] Trying to capitalize on the "low-carb craze," many companies released special product lines that were low in carbohydrates. In 2003, Atkins died from a fatal head injury sustained in a fall on ice.[22] On July 31, 2005, the Atkins Nutritional company filed for Chapter 11 bankruptcy protection after the percentage of adults on the diet declined to two percent and sales of Atkins brand product fell steeply in the second half of 2004.[23] The company continues to operate and the diet plan remains popular, although it has not regained its former popularity.